The Diagnosis of James River Ringworm – an example of Historical Disease Mapping & Predictive Modeling

Posted by Brian Altonen, MPH, MS under Uncategorized Comments Off on The Diagnosis of James River Ringworm – an example of Historical Disease Mapping & Predictive Modeling

In 1982 I purchased a copy of Benjamin Smith Barton ’s writing Collections for an Essay towards a Materia Medica of the United States (3vols, Philadelphia, 1804). In this book he made a statement about a geographical disease referred to as James River Ringworm which first appeared in slave populations residing on lands owned by Thomas Jefferson’s family.

This led me to pose a series of research questions, which 30 years later I was finally able to answer. These questions were . . .

1) What exactly was the James Fever Ringworm?

2) Was it truly an endemic or epidemic disease like Barton suggested, or short lived?

The cause for James River Ringworm was important to because I decided it was either a result of the living conditions that slaves had to endure, or it was due to the transport of this disease from Africa. In a lengthy, very drawn out review of this "epidemic" for the VIrginias, I learned that it was also related to a disease that appeared along the shores of other nearby rivers according to French writer Louis Valentin, ca. 1796-1805. It also appeared to be very much wilderness related, could it have also been zoonotic in nature?

By a simple probabilities map of the region, using spatial concepts to define the different ways this disease may have evolved, I came up with several theories as to how it made its way to the region.

By reviewing basic transportation routes for the time, population densities for the slave camps, the places where it existed and their natural ecology, I was able to determine where the disease prevailed the most, and more importantly what it’s probable cause was based on physical geographic and climate-weather features.

Several times a year I am contacted about my study of this epidemic history. Currently, historical microbial pathology specialists are frequently turning to past research and writings to determine if the fungal diseases noted today as new to a region are in fact simple a rediscovery of these past regional disease patterns.

In particular, the complications of post surgical patients healing and recovery processes due to local fungal and bacterial contamination of slow healing organ transplant and ulcer injuries seem to be linked to, of all things, soil chemistry and the way soil plays such an important role in spore production and infection of open sores and wounds. Of all places, this is a primary research endeavor by a colleague of mine at a Long Island teaching hospital dedicated to high technology research in the medical sciences.

When I began this research in 1982, I had no reason to pursue it much, until the realization that there was certainly a topography and climatology reason for this purportedly regional epidemic pattern. The diagnosis I came up with for James River Ringworm was very amusing once it became clear which one of the four species most likely responsible for it was the probable cause. We missed this obvious clue to a cause for this epidemic impacting Jefferson’s slaves due to our modern interpretation of this disease. Jock Itch or Athlete’s fungus took on a very different appearance when it first appeared as an epidemic during the early years of Virginia Colony and United States medical history.